Individuals

Your Money Awaits

The form below is simple to fill out and asks the basic information to help us understand your funding needs. Your information will be kept confidential, and we'll only ask questions that help us learn how we can best serve you.

Name *

Name

First Name

Last Name

Email Address *

Phone *

Phone

(###)

###

####

Address *

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What is your case about? *

Auto Accident

Motorcycle Accident

Trucking Accident

Medical Malpractice

Wrongful Death

Other

Is your case currently in litigation?

Yes

No

What type(s) of injury have been sustained?

Date of Accident

Date of Accident

MM

DD

YYYY

If this case is about a minor, and you are their legal guardian, what is the minor's name?

If this case is about a minor, and you are their legal guardian, what is the minor's name?

First Name

Last Name

Relationship to minor, if applicable

How much money do you need? *

$

Your Attorney's Name *

Your Attorney's Name

First Name

Last Name

Your Attorney's Firm *

Your Attorney's Email

Your Attorney's Phone Number

Your Attorney's Phone Number

(###)

###

####

Is there any other information you'd like to share?

Please do not include confidential or sensitive information in your message.

Thank you for your application. We will get back to you as soon as possible with the results of your funding.

➤ Stop worrying. Start living.

Our pre-settlement funding solutions will quickly provide you with the cash you need to get back on your feet.

Remember, you only pay if you win.

➤ COVERAGE AREA

Our services are currently available for cases pending in Georgia.

➤ AVAILABILITY

Apply Now. Get a funding decision within 24-hours.

➤ Easy process

After your request for funding is approved, we will send your attorney a contract. Once signed, you will receive funds within 24 hours.